المؤلفون: Dotinga, Baukje M.¹ b.m.dotinga@umcg.nl, de Winter, Andrea F.², Bocca-Tjeertes, Inger F. A.¹, Kerstjens, Jorien M.¹, Reijneveld, Sijmen A.², Bos, Arend F.¹

المصدر: PLoS ONE. 1/31/2019, Vol. 14 Issue 1, p1-11. 11p.

مصطلحات موضوعية: *CHILD development, *PREMATURE labor, *SOCIOECONOMICS, *CHILDBIRTH, *BIRTH weight

مستخلص: Objectives: Moderately and late preterm children (MLPs, 32.0–36.9 weeks gestational age) have a greater risk of poorer growth. This seems to be associated with poorer neuropsychological functioning. Evidence is limited on whether this also holds for emotional and behavioral (EB) problems. Therefore, we assessed whether longitudinal growth from birth until age 7 was associated with EB problems at age 7 in MLPs. Study design: This study was part of the Longitudinal Preterm Outcome Project, a prospective cohort study. Data on growth (height, weight, head circumference, and extent of catch-up growth) were obtained from assessments from birth until age 7. EB problems were assessed at age 7 with the Child Behavior Checklist. We assessed whether growth and EB problems were associated using logistic regression analyses, adjusting for multiple birth, parity, and socioeconomic status. Results: We included 248 MLPs. Median gestational age was 34 weeks (interquartile range: 33–35 weeks). Mean birth weight was 2.2 kg (standard deviation: 0.5 kg). Postnatal growth measures were below the Dutch reference norm. EB problems were more prevalent in MLPs than in the general Dutch population. Generally, we found no associations between growth and EB problems; odds ratios ranged from 0.20 to 2.72. Conclusions: In MLPs, postnatal growth from birth until age 7 was not associated with EB problems at age 7. Poorer growth thus seems to relate to neuropsychological problems, but not to EB problems. This suggests that the etiologies of these problems differ at least partially. [ABSTRACT FROM AUTHOR]

المصدر: Women's Health Weekly; 2024, p1179-1179, 1p

مصطلحات موضوعية: PREMATURE infants, PREMATURE labor, RESEARCH personnel, CHILDBIRTH, BLOOD proteins, FETAL physiology, CARRIER proteins

الشركة/الكيان: TECHNISCHE Universiteit Eindhoven

مستخلص: A recent report from researchers at Eindhoven University of Technology discusses the development of an extrauterine environment for extremely premature infants, known as Artificial Placenta and Artificial Womb (APAW) technology. This technology aims to provide an optimal environment for newborn development by allowing further lung maturation and delaying gas exposure to oxygen. The report analyzes relevant fetal physiology literature, provides insights from APAW studies, and identifies considerations for the obstetric procedure of transferring an infant from the native uterus to an APAW system. The researchers also provide suggestions to improve sterility, fetal and maternal well-being, and the prevention of neonatal transition. [Extracted from the article]

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المصدر: Women's Health Weekly; 2024, p965-965, 1p

مصطلحات موضوعية: LOW birth weight, PRENATAL care, RESEARCH personnel, CHILDBIRTH, LIFE sciences, PREMATURE labor

مستخلص: A recent study conducted by researchers from the University of Indonesia examined the association between antenatal care (ANC) utilization and low birth weight (LBW) children among women with high-risk births. The study utilized data from the 2017 Indonesia Demographic and Health Survey and found that adequate ANC utilization was significantly associated with LBW among women with more than two children. Preterm birth was also found to be more likely to result in LBW. The researchers concluded that there is a need for increased monitoring of pregnant women with high-risk births and for improved implementation of qualified ANC standards. [Extracted from the article]

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المؤلفون: Passini Jr, Renato¹ passini@caism.unicamp.br, Cecatti, Jose G.^1,2, Lajos, Giuliane J.¹, Tedesco, Ricardo P.^1,3, Nomura, Marcelo L.¹, Dias, Tabata Z.¹, Haddad, Samira M.¹, Rehder, Patricia M.¹, Pacagnella, Rodolfo C.¹, Costa, Maria L.¹, Sousa, Maria H.²

المصدر: PLoS ONE. Oct2014, Vol. 9 Issue 10, p1-12. 12p.

مصطلحات موضوعية: *PREMATURE infants, *PREMATURE labor, *CHILDBIRTH, *HEALTH facilities, *MULTIPLE pregnancy

مصطلحات جغرافية: BRAZIL

مستخلص: Background: Preterm birth rate is increasing and is currently a worldwide concern. The purpose of this study was to estimate the prevalence of preterm birth in a sample of health facilities in Brazil and to identify the main risk factors associated with spontaneous preterm births. Methods and Findings: This was a multicentre cross sectional study on preterm births in 20 referral obstetric hospitals with a case-control component to identify factors associated with spontaneous preterm birth. Surveillance was implemented at all centres to identify preterm births. For eligible consenting women, data were collected through a post-delivery questionnaire completed with information from all mother-newborn medical records until death or discharge or at a maximum of 60 days post-delivery, whichever came first. The risk of spontaneous preterm birth was estimated with OR and 95%CI for several predictors. A non-conditional logistic regression analysis was then performed to identify independently associated factors. The overall prevalence of preterm birth was 12.3%. Among them, 64.6% were spontaneous and 35.4% therapeutic. In the case-control component, 2,682 spontaneous preterm births were compared to a sample of 1,146 term births. Multivariate analyses identified the following as risk factors for spontaneous preterm birth among women with at least one previous birth: a previous preterm birth (ORadj = 3.19, 2.30–4.43), multiple pregnancy (ORadj = 29.06, 8.43–100.2), cervical insufficiency (ORadj = 2.93, 1.07–8.05), foetal malformation (ORadj = 2.63, 1.43–4.85), polyhydramnios (ORadj = 2.30, 1.17–4.54), vaginal bleeding (ORadj = 2.16, 1.50–3.11), and previous abortion (ORadj = 1.39, 1.08–1.78). High BMI (ORadj = 0.94, 0.91–0.97) and weight gain during gestation (ORadj = 0.92, 0.89–0.95) were found to be protective factors. Conclusions: The preterm birth rate in these health facilities in Brazil is high and spontaneous preterm births account for two thirds of them. A better understanding of the factors associated with spontaneous preterm birth is of utmost importance for planning effective measures to reduce the burden of its increasing rates. [ABSTRACT FROM AUTHOR]

المؤلفون: Barrett, Peter M., McCarthy, Fergus P., Evans, Marie, Kublickas, Marius, Perry, Ivan J., Stenvinkel, Peter, Kublickiene, Karolina, Khashan, Ali S.

المصدر: BMC Medicine; 4/1/2020, Vol. 18 Issue 1, p1-12, 12p, 4 Charts, 2 Graphs

مصطلحات موضوعية: KIDNEY diseases, CHRONIC kidney failure, LABOR complications (Obstetrics), CHILDBIRTH, PREMATURE labor, DISEASE risk factors, WOMEN'S health

مستخلص: Background: Preterm delivery is an independent risk factor for maternal cardiovascular disease. Little is known about the association between preterm delivery and maternal renal function. This study aimed to examine whether women who experience preterm delivery are at increased risk of subsequent chronic kidney disease (CKD) and end-stage kidney disease (ESKD).Methods: Using data from the Swedish Medical Birth Register, singleton live births from 1973 to 2012 were identified and linked to data from the Swedish Renal Register and National Patient Register (up to 2013). Gestational age at delivery was the main exposure and treated as a time-dependent variable. Primary outcomes were maternal CKD or ESKD. Cox proportional hazard regression models were used for analysis.Results: The dataset included 1,943,716 women who had 3,760,429 singleton live births. The median follow-up was 20.6 (interquartile range 9.9-30.0) years. Overall, 162,918 women (8.4%) delivered at least 1 preterm infant (< 37 weeks). Women who had any preterm delivery (< 37 weeks) were at increased risk of CKD (adjusted hazard ratio (aHR) 1.39, 95% CI 1.32-1.45) and ESKD (aHR 2.22, 95% CI 1.90-2.58) compared with women who only delivered at term (≥ 37 weeks). Women who delivered an extremely preterm infant (< 28 weeks) were at increased risk of CKD (aHR 1.84, 95% CI 1.52-2.22) and ESKD (aHR 3.61, 95% CI 2.03-6.39). The highest risk of CKD and ESKD was in women who experienced preterm delivery + preeclampsia (vs. non-preeclamptic term deliveries, for CKD, aHR 2.81, 95% CI 2.46-3.20; for ESKD, aHR 6.70, 95% CI 4.70-9.56). However, spontaneous preterm delivery was also associated with increased risk of CKD (aHR 1.32, 95% CI 1.25-1.39) and ESKD (aHR 1.99, 95% CI 1.67-2.38) independent of preeclampsia or small for gestational age (SGA).Conclusions: Women with history of preterm delivery are at increased risk of CKD and ESKD. The risk is higher among women who had very preterm or extremely preterm deliveries, or whose preterm delivery was medically indicated. Women who experience spontaneous preterm delivery are at increased risk of long-term renal disease independent of preeclampsia or SGA. Preterm delivery may act as a risk marker for adverse maternal renal outcomes. [ABSTRACT FROM AUTHOR]

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المؤلفون: Ratnasiri, Anura W. G., Lee, Henry C., Lakshminrusimha, Satyan, Parry, Steven S., Arief, Vivi N., DeLacy, Ian H., Yang, Jo-Shing, DiLibero, Ralph J., Logan, Julia, Basford, Kaye E.

المصدر: PLoS ONE; 9/19/2019, Vol. 14 Issue 9, p1-21, 21p

مصطلحات موضوعية: FETAL macrosomia, BODY mass index, PREMATURE labor, CHILDBIRTH, CESAREAN section, COHORT analysis

مصطلحات جغرافية: CALIFORNIA

مستخلص: Objective: To determine recent trends in maternal prepregnancy body mass index (BMI) and to quantify its association with birth and maternal outcomes. Methods: A population-based retrospective cohort study included resident women with singleton births in the California Birth Statistical Master Files (BSMF) database from 2007 to 2016. There were 4,621,082 women included out of 5,054,968 women registered in the database. 433,886 (8.6%) women were excluded due to invalid or missing information for BMI. Exposures were underweight (BMI < 18.5 kg/m²), normal weight (18.5–24.9 kg/m²), overweight (25.0–29.9 kg/m²), and obese (≥ 30 kg/m²) at the onset of pregnancy. Obesity was subcategorized into class I (30.0–34.9 kg/m²), class II (35.0–39.9 kg/m²), and class III (≥ 40 kg/m²), while adverse outcomes examined were low birth weight (LBW), very low birth weight (VLBW), macrosomic births, preterm birth (PTB), very preterm birth (VPTB), small-for-gestational-age birth (SGA), large-for-gestational-age birth (LGA), and cesarean delivery (CD). Descriptive analysis, simple linear regression, and multivariate logistic regression were performed, and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) for associations were estimated. Results: Over the ten-year study period, the prevalence of underweight and normal weight women at time of birth declined by 10.6% and 9.7%, respectively, while the prevalence of overweight and obese increased by 4.3% and 22.9%, respectively. VLBW increased significantly with increasing BMI, by 24% in overweight women and by 76% in women with class III obesity from 2007 to 2016. Women with class III obesity also had a significant increase in macrosomic birth (170%) and were more likely to deliver PTB (33%), VPTB (66%), LGA (231%), and CD (208%) than women with a normal BMI. However, obese women were less likely to have SGA infants; underweight women were 51% more likely to have SGA infants than women with a normal BMI. Conclusions: In California from 2007 to 2016, there was a declining trend in women with prepregnancy normal weight, and a rising trend in overweight and obese women, particularly obesity class III. Both extremes of prepregnancy BMI were associated with an increased incidence of adverse neonatal outcomes; however, the worse outcomes were prominent in those women classified as obese. [ABSTRACT FROM AUTHOR]

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المؤلفون: Heng, Yujing Jan¹ heng@lunenfeld.ca, Pennell, Craig Edward², Chua, Hon Nian³, Perkins, Jonathan Edward¹, Lye, Stephen James¹

المصدر: PLoS ONE. May2014, Vol. 9 Issue 5, p1-13. 13p.

مصطلحات موضوعية: *PREMATURE labor, *GENE expression profiling, *CHILDBIRTH, *UTERINE contraction, *PREGNANCY, *HOSPITAL admission & discharge, *THERAPEUTICS

مستخلص: Threatened preterm labor (TPTL) is defined as persistent premature uterine contractions between 20 and 37 weeks of gestation and is the most common condition that requires hospitalization during pregnancy. Most of these TPTL women continue their pregnancies to term while only an estimated 5% will deliver a premature baby within ten days. The aim of this work was to study differential whole blood gene expression associated with spontaneous preterm birth (sPTB) within 48 hours of hospital admission. Peripheral blood was collected at point of hospital admission from 154 women with TPTL before any medical treatment. Microarrays were utilized to investigate differential whole blood gene expression between TPTL women who did (n = 48) or did not have a sPTB (n = 106) within 48 hours of admission. Total leukocyte and neutrophil counts were significantly higher (35% and 41% respectively) in women who had sPTB than women who did not deliver within 48 hours (p<0.001). Fetal fibronectin (fFN) test was performed on 62 women. There was no difference in the urine, vaginal and placental microbiology and histopathology reports between the two groups of women. There were 469 significant differentially expressed genes (FDR<0.05); 28 differentially expressed genes were chosen for microarray validation using qRT-PCR and 20 out of 28 genes were successfully validated (p<0.05). An optimal random forest classifier model to predict sPTB was achieved using the top nine differentially expressed genes coupled with peripheral clinical blood data (sensitivity 70.8%, specificity 75.5%). These differentially expressed genes may further elucidate the underlying mechanisms of sPTB and pave the way for future systems biology studies to predict sPTB. [ABSTRACT FROM AUTHOR]

المؤلفون: Jamali, Qamar Zaman, Shah, Rashed, Shahid, Farhana, Fatima, Aisha, Khalsa, Saraswati, Spacek, Jana, Regmi, Presha

المصدر: PLoS ONE; 6/17/2019, Vol. 14 Issue 6, p1-15, 15p

مصطلحات موضوعية: HEALTH facilities, FOCUS groups, PREMATURE labor, CHILDBIRTH, PREMATURE infants, BIRTH rate

مصطلحات جغرافية: PAKISTAN, SINDH (Pakistan)

مستخلص: Background: More than 2.5 million newborns die each year, accounting for 47% of children dying worldwide before their age of five years. Complications of preterm birth are the leading cause of death among newborns. Pakistan is amongst the top ten countries with highest preterm birth rate per 1000 live births. Globally, Every Newborn Action Plan (ENAP) has emphasized on Kangaroo Mother Care (KMC) as an essential component of neonatal health initiatives. Materials and methods: We conducted this qualitative study with 12 in-depth interviews (IDIs) and 14 focus group discussion (FGD) sessions, in two health facilities of Sindh, Pakistan during October-December 2016, to understand the key barriers and enablers to a mother's ability to practice KMC and the feasibility of implementing and improving these practices. Results: The findings revealed that community stakeholders were generally aware of health issues especially related to maternal and neonatal health. Both the health care providers and managers were supportive of implementing KMC in their respective health facilities as well as for continuous use of KMC at household level. In order to initiate KMC at facility level, study respondents emphasized on ensuring availability of equipment, supplies, water-sanitation facility, modified patient ward (e.g., curtain, separate room) and quality of services as well as training of health providers as critical prerequisites. Also in order to continue practicing KMC at household level, engaging the community and establishing functional referral linkage between community and facilities were focused issues in facility and community level FGDs and IDIs. Conclusion: The study participants considered it feasible to initiate KMC practice at health facility and to continue practicing at home after returning from facility. Ensuring facility readiness to initiate KMC, improving capacity of health providers both at facility and community levels, coupled with focusing on community mobilization strategy, targeting specific audiences, may help policy makers and program planners to initiate KMC at health facility and keep KMC practice continued at household level. [ABSTRACT FROM AUTHOR]

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المؤلفون: Ferguson, Kelly K., Rosario, Zaira, McElrath, Thomas F., Vélez Vega, Carmen, Cordero, José F., Alshawabkeh, Akram, Meeker, John D.

المصدر: PLoS ONE; 6/13/2019, Vol. 14 Issue 6, p1-15, 15p

مصطلحات موضوعية: LABOR (Obstetrics), CHILDBIRTH, PREGNANT women, DISEASE risk factors, BIRTH rate, PREMATURE labor

مصطلحات جغرافية: PUERTO Rico

مستخلص: Preterm birth is a major public health problem, especially in Puerto Rico where the rates are among the highest observed worldwide, reaching 18% in 2011. The Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) study is an ongoing investigation of environmental factors that contribute to this condition. In the present analysis, we sought to examine common risk factors for preterm birth and other adverse birth outcomes which have not been characterized previously in this unique population. Pregnant women from the PROTECT cohort are recruited from the heavily contaminated Northern coast of the island of Puerto Rico and are free of pre-existing conditions like diabetes. We examined associations between basic demographic, behavioral (e.g., tobacco and alcohol use), and pregnancy (e.g., season and year of delivery) characteristics as well as municipality of residence in relation to preterm birth (<37 weeks gestation), postterm birth (≥41 weeks gestation), and small and large for gestational age in univariate and multivariate logistic regression models. Between 2011 and 2017, 1028 live singleton births were delivered as part of the PROTECT cohort. Of these, 107 (10%) were preterm. Preterm birth rates were higher among women with low socioeconomic status, as indicated by education level and income, and among women with high pre-pregnancy body mass index (BMI). Odds ratios of small for gestational age delivery were higher for women who reported tobacco use in pregnancy and lower for women who delivered in the hurricane and dengue season (July-October). Overall, in pregnant women residing in Puerto Rico, socioeconomic status was associated with preterm birth but few other factors were associated with this or other adverse outcomes of pregnancy. Research to understand environmental factors that could be contributing to the preterm birth epidemic in Puerto Rico is necessary. [ABSTRACT FROM AUTHOR]

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المؤلفون: Fuchs, Florent, Monet, Barbara, Ducruet, Thierry, Chaillet, Nils, Audibert, Francois

المصدر: PLoS ONE; 1/31/2018, Vol. 13 Issue 1, p1-10, 10p

مصطلحات موضوعية: MATERNAL age, PREGNANCY, PREMATURE labor, CHILDBIRTH, MULTIPLE pregnancy, PREGNANCY complications

مستخلص: Background: Maternal age at pregnancy is increasing worldwide as well as preterm birth. However, the association between prematurity and advanced maternal age remains controversial. Objective: To evaluate the impact of maternal age on the occurrence of preterm birth after controlling for multiple known confounders in a large birth cohort. Study design: Retrospective cohort study using data from the QUARISMA study, a large Canadian randomized controlled trial, which collected data from 184,000 births in 32 hospitals. Inclusion criteria were maternal age over 20 years. Exclusion criteria were multiple pregnancy, fetal malformation and intra-uterine fetal death. Five maternal age categories were defined and compared for maternal characteristics, gestational and obstetric complications, and risk factors for prematurity. Risk factors for preterm birth <37 weeks, either spontaneous or iatrogenic, were evaluated for different age groups using multivariate logistic regression. Results: 165,282 births were included in the study. Chronic hypertension, assisted reproduction techniques, pre-gestational diabetes, invasive procedure in pregnancy, gestational diabetes and placenta praevia were linearly associated with increasing maternal age whereas hypertensive disorders of pregnancy followed a “U” shaped distribution according to maternal age. Crude rates of preterm birth before 37 weeks followed a “U” shaped curve with a nadir at 5.7% for the group of 30–34 years. In multivariate analysis, the adjusted odds ratio (aOR) of prematurity stratified by age group followed a “U” shaped distribution with an aOR of 1.08 (95%CI; 1.01–1.15) for 20–24 years, and 1.20 (95% CI; 1.06–1.36) for 40 years and older. Confounders found to have the greatest impact were placenta praevia, hypertensive complications, and maternal medical history. Conclusion: Even after adjustment for confounders, advanced maternal age (40 years and over) was associated with preterm birth. A maternal age of 30–34 years was associated with the lowest risk of prematurity. [ABSTRACT FROM AUTHOR]

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